This article originally appeared in the July-August 2005 issue of the Children's Advocate, published by Action Alliance for Children.

"Guaranteeing that kids are healthy"

Advocates push to make all California kids eligible for affordable health insurance

By Kevin Hickey

Maria Garcia’s job doesn’t offer health insurance. And she couldn’t afford to pay for checkups for her four children. “Just to get physicals done was really hard. The cost was way high,” she says—but her children couldn’t start school on time without required checkups and shots. She also worried about her 16-year-old son Abraham, who has asthma.

Now her children are covered by Santa Clara County’s Healthy Kids program (see Insurance). “Knowing that I can take them (to the doctor) instead of not going because of cost gives me peace of mind,” she says.

A recent poll shows that 80 percent of California voters support expanding free and low-cost public health insurance to cover all uninsured children—and a new coalition of advocates, parents, health providers, businesses, and policy makers, is pushing hard to make that happen this year.

“A significant difference”

While 90 percent of children in California already have health insurance, nearly 800,000 do not—some are eligible for, but not enrolled in, state health insurance programs. Others do not qualify because their families’ incomes are too high or they are undocumented immigrants.

“Providing health coverage to children makes a significant difference in (their) access to health care,” says Leona Butler, CEO of the Santa Clara County Family Health Plan.

• Better for kids: Children without health insurance are in poorer health, less likely to get needed care, and more likely to do poorly in school (see "Research"). Providing public health insurance for undocumented immigrants is controversial, but “just like public education, (these children) should have access to public health benefits,” says Deena Lahn, policy director for Children’s Defense Fund California. “Should they not be able to focus in school because of a tooth ache?”

• Better for families: The cost of care for an accident or illness can create a crisis for families without good insurance—one report found medical bills caused nearly half of bankruptcies in 2001.

• Better for society: With recent cuts to public health clinic funds, families without insurance end up in emergency rooms more often than insured families because they are not getting preventative care—and if they can’t pay for these expensive visits, experts say, everyone picks up the tab through higher insurance premiums and taxes.

Californians for Healthy Kids

Last December, advocacy organizations for children and families came together to push for affordable health insurance for all children in California. The 100% Campaign—coordinated by Children Now, The Children’s Partner-ship and Children’s Defense Fund California—and Pacific Institutes for Community Organizing California spearhead a coalition including teachers, parents, businesses, doctors, and community leaders.

At a town hall meeting in East Los Angeles, families testified about the benefits of the Los Angeles Children’s Health Initiative (see Insurance). An April town hall meeting in Sacramento drew more than 4,000 supporters—including Assembly Speaker Fabian Nunez and Senate President Pro Tem Don Perata.

The campaign is working to:

• Get kids into Medi-Cal and Healthy Families. More than half of children without health insurance qualify for free and low-cost state health insurance. Advocates want to make sure that they get enrolled.

• Build on local initiatives. Local health insurance initiatives, such as Santa Clara’s Healthy Kids, are reaching their capacity and running out of money, says a report from the UCLA Center for Health Policy Research. Advocates are “working really close with the county programs,” says Lahn.

• Get business involved. A survey of employers found that the number one issue affecting small businesses is health insurance—“80 percent of employers support expanding Heal-thy Families,” says Scott Hauge, founder of Small Business California. Advocates will ask employers to participate—perhaps by paying their employee’s children’s public health insurance premiums.

• Outreach to the uninsured with the message that any child can have insurance. “Most (uninsured) families are a mix of documented and undocumented kids. Most kids are already eligible for public health benefits, but there’s confusion in the families” so they don’t enroll anyone, says Lahn.

Funding

“We’re already spending the money,” adds Lahn, “in the emergency rooms instead of preventative care.” Experts say insuring all children in California would cost between $131 million and $313 million per year—but the state already spends most of that to un-enroll children (for example, because of changes in income, delays in paperwork, and errors) and re-enroll them later, says a recent California Endowment study.

Advocates are pushing for children’s health insurance bills that would

• maximize federal matching funds

• charge premiums based on income for newly eligible children

• start a children’s health care trust fund funded by tax amnesty payments and grants.

Garcia now sits on the consumer advisory board for the Santa Clara County’s Family Health Plan, where she advises doctors and plan administrators about serving families and does outreach. “Push until you get it,” she urges. “It’s for guaranteeing that kids are healthy—and that’s important!”

For more information

• 100% Campaign, 510-663-2984, www.100percentcampaign.org/

• PICO California, 916-447-7959, x11

• Sign up for email alerts at www.100percentcampaign.org

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Research says ...

• Uninsured children are less likely to get check-ups, dental care, prescriptions, glasses, and immunizations—and 40 percent less likely to get care for a serious injury. (USA Foundation, 1997; American College of Physicians, 2001)

• Healthy Families achieved “dramatic, sustained improvements for children in the poorest health”—and participating kids kept up better in school. ( California MRMIB, 2004)

• The Santa Clara County Children’s Health Initiative met more than half of participating children’s unmet medical needs, tripled their access to dental care, and doubled preventative visits. (Mathematica Policy Research, 2005)

Legislation

Advocates urge people to contact their legislators and express their views about the California Healthy Kids Insurance Program (AB 772, Chan, and SB 437, Escutia). They would

• Expand Healthy Families and provide affordable insurance for children who don’t qualify because of immigration status or family income

• Make it easier for children to get and stay enrolled

• Provide grants and transition plans for county children’s health initiatives.

Current public health insurance options for kids

Comprehensive programs

• Medi-Cal: health, dental, and vision services for children in low-income families (undocumented immigrants only eligible for emergency and pregnancy services)

• Healthy Families: health, dental, and vision services for children in low- and moderate-income families whose income is too high for Medi-Cal (undocumented immigrants not eligible)

• California Kids: health, dental, and vision services for all children in low- and moderate-income families not eligible for Medi-Cal or Healthy Families—but funds are limited

• County children’s health initiatives: health insurance offered by many counties, typically for all children not eligible for Medi-Cal or Healthy Families

Specific programs

• Child Health Disability and Prevention Program: health assessments (including shots and exams) for all children in low-income families not on Medi-Cal

• Access for Infants and Mothers: health insurance for all low- and moderate-income pregnant women, infants, and toddlers

• California Children’s Services: treatment for serious medical problems for all children from low- and moderate-income families

For more information, visit www.100percentcampaign.org

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